This Is My Brave Now – A Guest Post by Kitt O’Malley

This is My Brave as I write these words. This is My Brave as I blog about living with bipolar disorder. This is My Brave as I use social media to advocate for mental health. This is My Brave as I train to volunteer educating others about my experience living with mental illness. This Brave enables me to stand up and speak out against mental health stigma and discrimination. Fellow mental health advocates have emboldened me. Together we are braver than we are apart. This Brave connects me to others. This Brave breaks down walls I constructed to protect myself. This Brave breaks down walls others construct to protect themselves from their fear of mental illness and of those living with mental illness.

For years I disguised depressive symptoms behind a mask of high achievement and perfectionism. As a college freshman, I grappled with suicidal thoughts, believing that the world would be better off without me. I did not tell my parents, for I did not want to disappoint them. I did not tell my college acquaintances. I kept my secret. Those friends I did tell made me promise to get help, which I did. The psychologist I saw practiced cognitive behavioral therapy which helped me to distance myself from my suicidal thoughts.

Finding my brave over the course of my life since then has been a gradual process. I spent my twenties in and out of therapy. By the time I was thirty years old, I had undergone years of psychotherapy, gotten a masters in psychology, became a licensed marriage and family therapist, worked at a battered women’s shelter, treated children and adolescents in day treatment, and adolescent girls in residential treatment, and counseled pregnant and parenting adolescents. As you can see, I was pretty deeply involved in the mental health field. Until one day I just could not, for the life of me, get out of bed. Not at all. This time, I called my parents and asked for their help. Crying over the phone, I told them that I just couldn’t do it anymore.

My parents flew up to help. All I had to do was ask. For the first time, I sought medical help for my depression. No longer did I try to tough it out using only psychotherapy, now I added psychiatric treatment and antidepressants to my arsenal. Unfortunately, tricyclic antidepressants triggered a week-long manic psychotic break, during which I did not sleep and thoughts raced through my mind faster than I could comprehend them. Since this break occurred in response to medication, I was not diagnosed bipolar at the time.

Recovery from this break involved moving back in with my parents. I took a temporary position with a commercial real estate firm that began a decade-long career in commercial real estate, a field not as emotionally demanding as psychology, but that took advantage of my still undiagnosed hypomanic symptoms.

My hypomanic symptoms were not yet included in the DSM diagnostic criteria for bipolar disorder. Instead, I was an overachiever diagnosed with chronic depression. I would tell doctors that I was at the very least cyclothymic, for I achieved more and produced more – way more – than others. I was a full-on workaholic. At work and in my personal life, I was honest and open about my diagnosis of depression. When undergoing dosage or medication changes, I informed my supervisors, for such changes often temporarily affected my behavior at the office.

At the age of thirty-nine, I began once again experiencing the euphoric sensation that God was calling me to do something. I recognized the symptom as mania and called the advice nurse, who recommended that I see a psychiatrist or go to the emergency room immediately. Upon receiving a diagnosis of bipolar disorder type II, I again openly shared my diagnosis with my employer.

In the workplace, with friends, and with acquaintances, I always found it more natural to be open and honest about my diagnosis. Having once been a mental health professional, I long had a passion for mental health. I knew that others could not see my illness. I knew that by sharing this fact I would challenge their assumptions.

Secrets are more damaging than openly being yourself. Once I hid behind perfectionism. As I became more accepting and forgiving of my own imperfection, of my humanity, as I showed myself the same compassion I once showed my clients, My Brave grew, grew to what it is today. This is My Brave now.

40 Comments

[…] and antidepressants. My work history during these years was one of many starts and stops, constantly overworking until I again became depressed. Finally, at the age of 39, it became clear that I had bipolar […]

Brave indeed. Thank you again for sharing so openly and honestly. There is someone in my life that I know well and I believe that person may suffer from Bi-polar disorder but they are unwilling to seek help. I found what you have written here very informative. Wish I knew how to reach out to this person effectively and carefully.

That I cannot answer for you. As an adult child of alcoholics, have let my parents know my stance on their drinking and on alcohol, but they are still a part of my life. Some give ultimatums. I accept that I cannot change my parents’ choices (though I remain a nag).

Excellent piece, Kitt. I thought this would be apt place to share a post I wrote about
Jennifer Marshall, co-founder with Anne Marie Ames of This Is My Brave, Inc.,, and author of the blog “Bipolar Mom Life”.

The only caveat would be if the reaction to self-revelation is likely to be worse than trying to keep it hidden. Like coming out as gay in Uganda or openly converting to Christianity in Saudi Arabia for example.

Since this break occurred in response to medication, I was not diagnosed bipolar at the time.

That’s a little odd, as the bipolar II category was first developed to explain why some apparent depression sufferers react so badly to antidepressants. A cynic might say it was done so in an attempt to blame diagnosticians for the problems caused by the drugs. It’s also used to blame the patients for only seeking treatment for depressive episodes and not hypomanic ones, thereby ‘misleading’ their diagnostician.

A more generous explanation would be that bipolar II was defined so that doctors would be more careful, eliminating possible bipolar before prescribing ADs. If so, the effort was forlorn. Even those with confirmed bipolar are receiving ADs at an ever increasing rate despite their confirmed role in switching, rapid cycling, suicidality and potentially violence inducing akathisia. In the US about 80% of medicated bipolar patients are prescribed ADs.

The actual result of the bipolar II category has been an unprecedented rise in people diagnosed with bipolar – especially children – and a resultant huge increase in the use of heavy duty psychiatric medication, particularly anti-psychotics and anti-convulsants which can have devastating side effects.

Ghaemi is no maverick anti-psychiatrist. He’s about as mainstream as it gets and strongly supports the appropriate use of psychiatric medication. However he is acutely aware of the steadily increasing mountain of evidence that anti-depressants are strongly associated with negative medium to long-term outcomes for bipolar sufferers and is concerned at the way prescribing practices continue to fly in the face of research. The STEP-BD study he references in the linked article was the most comprehensive trial of bipolar medication ever conducted. It found that the single greatest predictor of negative outcomes for rapid cycling bipolar patients was antidepressant use, even when adjusting for the initial severity of symptoms.

I have no doubt whatsoever that ADs make many bipolar sufferers feel better in the short term. Heroin is like that too.

I’m sure there’s nothing I could tell you about SSRI withdrawals (oops, SSRI discontiuation syndrome – we don’t say ‘withdrawals’ when speaking of legal mood altering drugs) that you don’t already know even better than I. So if you give them up you’ll be careful, have good personal and medical support and be ready for up to six weeks of discontinuation symptoms – including increased severity of depression – each time you reduce the dose. (David Healy recommends switching to an equivalent dose of liquid Prozac before tapering to make the process smoother).

Like I said, I’m sure you know all this but I thought I would be a good idea to mention it for the benefit of other blog readers.

If you and your p-doc decide to drop them I wish you the best of luck. My grandmother’s withdrawal from Zoloft was quite mild (a bit of insomnia and that weird ‘electroshock’ feeling in her hands and arms) but the improvement in her mood and functioning over the following month was spectacular. She still gets mood swings of course, and still takes lithium, but her baseline mood around which the swings fluctuate is now much better than at any time since my grandfather died. She hasn’t told me she wants to die since discontinuing the Zoloft – which is a big change.

Thank you for pointing out the dangers of stopping taking SSRIs, other antidepressants and psychotropics. I call the symptoms withdrawal – legal ramifications be damned. Not sure what we will decide or when. My meds are adjusted prn and seasonally.

Kitt, you are so blessed to have supportive parents. Mine just accused me of laziness, even though I was running a thriving solo practice when I had my breakdown. I know all too well how it feels to have to give up your passion because of your illness. If it doesn’t bring out your Brave, then you’re likely to give up entirely. I’ve known too many people who died because they felt their lives had ended with their dreams. The secret to that is to invite a different dream into your life. It usually is not what you’d thought you’d be dreaming. Keep your Brave on, and I’ll do my best to keep mine too!

Up to the point my parents quite literally rescued me I had been undergoing psychodynamic therapy and had been told that I was abused as a child and that it was why I was depressed. Yes, growing up in an alcoholic family is challenging. Yes, when drunk some say mean things. But without doubt, my parents loved me and would do just about anything for me. Their love was and remains fierce, as is my love for my son. (I’m reeling, feeling empathy for the horrific abuse Teriezin survived, but feeling incredible guilt nevertheless. I thought I was “only depressed” when I had my son. I was in treatment. My diagnosis was dysthymia. I had worked with children and adolescents and battered women as a therapist. Everything I did was to be the best mother I could possibly be. I acknowledge that at times I am a challenging mother to have, but at the same time, my son is deeply loved, indulged, and respected. He’s awesome, gorgeous, brilliant, and sensitive. We go out of our way to attend to his needs and desires.)

Kit, your bravery in sharing this post has educated me more than you know. My daughter suffers from anxiety and depression that come in bursts. I’ve come to believe that this may never really “go away.” Thank you!